Medicinal Leech Therapy in Urology: A PRISMA-Compliant Systematic Review
Battin AO, Hobeika N, Zdilla MJ (2023) · African Journal of Urology · n=12
Study Profile
- Design
- PRISMA-compliant systematic review of 12 unique medicinal leech therapy cases in urological contexts (MEDLINE/PubMed)
- Sample size (n)
- 12
- Intervention
- Medicinal leech therapy across 12 urological cases: 4 post-penile replantation, 2 post-scrotal hematoma, 2 post-neonatal bladder exstrophy repair, 1 refractory priapism, 3 penoscrotal edema in hormone refractory prostate carcinoma
- Comparator
- Within-cohort comparison across diverse urological indications
- Primary endpoint
- Clinical improvement and complications across urological leech therapy applications
- Primary result
- All 12 cases (100%) reported clinical improvement; venous congestion/hematoma cases noted decreased displaced blood volume; priapism case had decreased pain; penoscrotal edema cases had significant swelling reduction; no complications in 9 adult patients; 3 neonatal patients required blood products
- Follow-up duration
- Variable across included cases
- PMID
- 41684506
Key Findings
- First PRISMA-compliant urology-specific leech review
- 100% reported clinical improvement across 12 cases
- Diverse indications: replant, hematoma, exstrophy, priapism, edema
- No complications in 9 adult patients
- 3 neonatal cases required blood products (volume-related)
Limitations
- Small case pool (n=12 unique cases)
- Publication bias toward successful outcomes
- Heterogeneous indications limit cross-comparison
- No control groups available
- PRISMA methodology applied to case-level evidence
Clinical Implications
Battin 2023 establishes leech therapy as a viable urologic adjunct across diverse indications with favorable safety profile in adults. For US clinicians under K040187, this PRISMA review extends device application to refractory priapism, penoscrotal edema, and post-bladder exstrophy congestion contexts beyond the traditional flap-salvage indication. The neonatal blood product requirement highlights age-specific considerations.
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